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RMJ. 2012; 37(2): 142-147

Frequency triple hepatitis (hepatitis B and C and D virus) in HBs Ag positive patients

Shaikh K. Muhammad, Bashir A. Shaikh, Kouro M. Gurbakshani, Aziz U. Jalbani.

OBJECTIVES: To determine the frequency of triple hepatitis in HBsAg positive patients and observe the effect of triple hepatitis infection on liver function test and radiological parameters.
METHODS: 1713 HBsAg positive patients presenting at Hepatology Clinic of Chandka Medical College, Larkana during January 2008 to June 2011 were enrolled for study. After informed written consent, blood samples were drawn for detection of anti-HDV Antibodies, anti – HCV antibodies on ELISA, HBV DNA, HCV RNA and HDV RNA on PCR and liver function tests (LFT). Ultrasound of all patients was performed. The data was transferred and analyze using SPSS version 19. Chi-square test was applied to compare the serological, biochemical and radiological profile of Triple Hepatitis (TH) positive and negative patients. Odd ratios were calculated when and where applicable. P value less than 0.05 was taken as statistically significant.
RESULTS: Of 1713 patients, anti-HCVAb was detected in 420 (24.5%), anti-HDVAb in 1116 (65.1%), HBV DNA in 308 (18%), HCV RNA in 148 (8.6%) and HDV RNA in 896 (52.3%). 268 (15.6%) had triple hepatitis (HBV+HCV+HDV). 220 (82.1%) of TH positive patients were male (p < 0.000). LFT were significantly elevated and ultrasonological examination of abdomen reported advanced chronic liver disease in triple hepatitis.
CONCLUSION: Triple Hepatitis infection was documented in 15.6% HBsAg positive patients. Males were more likely to be harboring triple viral hepatitis. Infected patients had advanced liver disease.

Key words: HBsAg, HBV DNA, anti-HCV Ab, HCV RNA, anti-HDV Ab, HDV RNA.

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